The Return on Men's Health

Executive summary

Men's health has moved from an unmet need to a defined benefits category. Published frameworks — Mercer's and WTW's among them — converge on the same clinical scope: cardiovascular and chronic disease prevention, cancer early detection, reproductive health, mental health and substance use, and sleep and lifestyle risk [1], [2]. Wherever the category is drawn, it is drawn around the same conditions.

The category exists because the spend already exists. What is missing is engagement: 65% of men avoid going to the doctor as long as possible, and 55% do not receive regular screening [2]. Care that is deferred is not care that is avoided — it arrives later, at a higher stage, and at a higher price.

Bastion Health is a virtual center of excellence for men's specialty care. It reaches men through their employer, diagnoses and treats them at home, and bills as a medical claim at a bundled case rate — no per-employee-per-month fee, no implementation fee, no eligibility file.

Savings opportunity

For an employer with 10,000 adult male members, Bastion's bottom-up model projects $1.5M to $3.0M in reduced medical cost in the first program year, against a program cost of $507,345. The range runs from a conservative case, in which half the modeled savings are realized, to the full modeled result.

Source: Bastion Health ROI Value Calculator v4 (August 2026), Bottom-Up model.

Three properties of the structure matter as much as the size of the projection. Pricing is consumption-based, so the employer pays only when care is delivered and low engagement reduces cost and savings together rather than stranding a fixed fee. The model is built on Bastion's observed 10.8% activation rate — the low-engagement case, against a book-of-business range that runs higher [3]. And the financial guarantee is contractual at 1:1, measured against actual Bastion claims [4].

Why men's health

Men's health is now treated as a distinct benefits category rather than a collection of unrelated point solutions. Two of the frameworks published to date scope it as follows.

Two independent frameworks, near-identical scope. That consistency is the useful signal: the category is defined well enough to build a program against, whichever advisory framework an employer works from.

Those domains are also where male medical claims concentrate. Bastion covers each of them.

Bastion's program set maps to the scope of the category, not to any one advisory framework.

Bastion additionally covers prostate enlargement, urinary tract infection and symptoms, sexual and hormonal health, and STD/STI screening — the urologic conditions that account for the majority of men's specialty claims and that sit outside those summary frameworks [5].

The population is large and under-engaged. More than 85 million men in the United States live with a preventable or treatable condition, and over half do not engage with traditional care [6]. Prevalence across an adult male workforce is broad: cardiovascular disease affects 1 in 2 men, metabolic disease 1 in 3, prostate enlargement 1 in 2 men after age 45, and low testosterone 1 in 4 men after age 30 [6].

Where the cost accumulates

Stage at diagnosis

The largest single driver in this analysis is the cost difference between early and late diagnosis, which is well quantified in US commercial claims.

Detecting one prostate cancer at Stage I rather than Stage IV is worth $86,652 in avoided annual treatment cost; one colorectal cancer found at Stage II rather than Stage IV, $127,974 [7]. Those two figures are the unit values the model applies to each earlier detection. Advanced prostate cancer diagnoses rose 41% over the past decade and advanced colon cancer 49%, while the survival rate at early stage remains 99% and 91% respectively [8].

Chronic disease

Prediabetes carries an incremental cost of $2,671 per member per year that compounds if progression is not interrupted [9], and 41% of US men meet the criteria [10]. Untreated hypogonadism carries a documented cost burden of $2,357 per member per year among privately insured men [11].

Access

Sixty-two percent of US counties have no urologist, and only 9.1% of urology practices are located outside metropolitan areas [5]. For a geographically distributed employer population, specialty access is a structural constraint rather than a motivational one.

The Bastion model

Clinical scope. Prostate health, cardio-metabolic screening, sexual and hormonal health, reproductive health, cancer and wellbeing screening, and STD/STI screening, delivered against medical guidelines and stratified by age [5]. Enrolled members average roughly two programs each, because the conditions co-occur [3].

Delivery. More than 60 board-certified urologists covering all 50 states, supported by nurse practitioners, at-home blood, urine, semen and stool diagnostics, and a dedicated care coordinator per patient [5]. Health coaching and navigation are included at no cost. The member path runs from app onboarding through a nurse practitioner visit, at-home diagnostics and a urologist visit to treatment and ongoing management, with referral out for complex cases and notes returned to the member's primary care physician.

Pricing. Assessment episodes are priced at $450 to $675 and treatment episodes at $700 to $950, all-in: consults, diagnostics, treatment and coordination [5], [12]. There is no PEPM or PMPM fee and no implementation fee.

Billing rule. Bundles do not stack. When a member selects several overlapping programs, only the primary package is billed and the clinically subsumed add-ons are not [5]. A 42-year-old presenting with low energy, low libido and difficulty conceiving is billed $675 rather than $1,775. A 59-year-old selecting four programs is billed $900 for the two that are clinically distinct. Comorbidity increases the clinical work performed without a proportional increase in what the employer pays.

Implementation. The program runs through the existing health plan as a medical claim, on the TPA relationship already in place. Launch requires only a marketing and communications agreement — no eligibility file, no employer database access, no implementation fee — and contracting, marketing, clinical configuration and go-live run in sequence over a matter of weeks. Bastion is SOC 2 Type 2 and HIPAA compliant, and reporting returns de-identified aggregate data on engagement, demographics, conditions, diagnoses, outcomes and satisfaction [5].

Savings opportunity

Direct cost of care

At in-network commercial rates, the assessment and treatment volume for 575 patients costs the plan $1,112,657 per year. At Bastion's bundled case rates, the identical case mix costs $507,345 — a direct saving of $605,312, or 54% [13], [12].

This component requires no assumption about downstream disease, no modeled avoidance and no behavior change. It is a price comparison on care the plan is already buying.

Composition of the savings

Direct price reduction accounts for a fifth of the modeled total. The majority comes from detecting disease at a stage where treatment costs less.

A prostate procedure in a hospital operating room carries an average allowed amount of $39,650.58; the same episode at an ambulatory surgery center costs $22,600.83 [13], [17]. At 4.8 redirected cases the line contributes $81,839, and it scales with surgical progression in the population.

Opportunity by activation rate

Activation determines the size of the opportunity. Because every cost and savings line in the model is computed per case, both scale with enrollment and the ratio between them does not change.

At the observed rate, modeled savings represent 1.69% of the employer's total healthcare spend of $174,960,000 [18], recovered from a single population segment.

How the model is built

The analysis is a bottom-up actuarial model. It starts from Bastion's observed enrollment and utilization, prices each element at contracted rates, and compares against commercial claims benchmarks for the identical case mix. It does not begin from an assumed percentage of medical spend.

Every savings line is computed as (cases) × (cost per case), where case counts come from Bastion's book of business and unit costs come from published US claims literature or from the Artemis benchmark database of 100,000 commercial lives [13]. No line is asserted without both.

Derivation

Case counts are rounded to one decimal for display; each total is computed on the unrounded count, so multiplying the displayed figures will not always reproduce the total exactly. Savings per patient in care: $5,134.33.

Performance guarantees

Bastion contracts against guarantees measured and reported through the program year [4].

The guaranteed financial floor is 1:1. The modeled result at observed activation is 5.82×, and the conservative case is 2.91×.

Conclusion

Men's health is now a defined benefits category with an established clinical scope, and the spend it describes already sits in the employer's plan. It arrives late because men engage late, and late arrival is expensive in ways the claims literature quantifies precisely — $86,652 for a prostate cancer found at Stage I rather than Stage IV, and $127,974 for a colorectal cancer found at Stage II rather than Stage IV.

Bastion delivers that clinical scope virtually, at 54% below in-network rates, on consumption-based pricing with no fixed fee. For 10,000 adult male members, the modeled first-year opportunity is $1.5M to $3.0M against $507,345 of program cost, with a contractual floor of 1:1.

References

This analysis reflects Bastion Health's book of business and published US cost literature. Modeled returns are a pre-contract estimate and are not a guarantee of outcomes for any prospective client. Program fees are confidential and exclusive to Bastion clients.